ARTEFACTS

IN CT SCAN
RUMBIDZAI
DEWERE
SIMBARASHE
NYENGERE
 TO
ADDR
• DEFINITION OF TERMS

ESS
• PHYSICS BASED ARTEFACTS
• PATIENT PROPERTIES BASED
ARTEFACTS
• SCANNER BASED ARTEFACTS
• HELICAL AND MULTISCLICE
ARTEFACTS
INTROD
UCTION
• Artifacts are any errors in the perception or representation
of any information introduced by modalities or techniques
• Ct artifacts are common and can occur for various reasons
• CT artifacts can seriously degrade CT images and make
images diagnostically unstable
• Knowledge of these artifacts is important because they can
mimic pathology or can degrade image to non-diagnostic
levels
INTROD
UCTION
Artefact refers to any systematic
discrepancy between the CT
numbers in the reconstructed image
and the true attenuation coefficients
of the object
 CLASSIFICATION
• Ct artifacts can be classified according to the underlying cause of the artifacts
• Physics –based artifacts- result from physical processes involved in acquisition
data
• Patient based artifacts-these are caused due to patient movement or presence of
metallic materials in or in patients
• Scanner -based artifacts-these are due to imperfections in scanner function
• Helical and multi-section technique artifacts- thee are produced by image
reconstruction process
 1. Patient based
• These are
• Presence of metallic materials
• Patient motion
• Incomplete projections
 Metallic materials
• The presence of metal objects in the scan field can lead to severe
streaking artifacts.
• The metal produces a beam hardening and photon starvation artefact
• This can also happen with other high attenuation materials such as iv
contrast
• They occur because the density of the metal is beyond the normal
range that can be handled by the computer ,resulting in incomplete
attenuation profiles
Metallic materials
 Avoidance
• Patients are normally asked to take off removable metal objects such as
jewelry before scanning commences
• For non-removable items such as dental fillings ,prosthetics
devices ,and surgical clips ,it is sometimes possible to use gantry
angulation to exclude the metal inserts from scans of nearby anatomy
• When it is impossible to scan the required anatomy without including
metal objects ,increasing technique ,especially kilovoltage ,may help
penetrate some objects ,and using thin sections will reduce the
contribution due to partial volume artifact
 Software correction
• Streaking caused by overranging can be greatly reduced by means of
special software corrections.
• Manufacturers use a variety of interpolation techniques to substitute
the overrange values in attenuation profiles.
• The usefulness of metal artifact reduction software is sometimes
limited because, although streaking distant from the metal implants is
removed, there still remains a loss of detail around the metal-tissue
interface, which is often the main area of diagnostic interest.
 Patient motion
• Motion artefact can be caused by patient swallowing ,breathing ,pulsating of
heart and vessels and patient moving
• If a patient or structure moves as the gantry rotates ,the object will be detected
being in several positions and represented as such
• Patient motion can cause misregistration artifacts, which usually appear as
shading or streaking in the reconstructed image .
• Steps can be taken to prevent voluntary motion, but some involuntary motion
may be unavoidable during body scanning
• However ,there are special features on some scanners designed to minimize the
resulting artifacts .
Patient motion
 Avoidance by operator
• The use of positioning aids is sufficient to prevent voluntary movement in most patients.
• However, in some cases (eg, pediatric patients), it may be necessary to immobilize the patient by means of s
• Using as short a scan time as possible helps minimize artifacts when scanning regions prone to movement.
• Respiratory motion can be minimized if patients are able to hold their breath for the duration of the scan.
• The sensitivity of the image to motion artifacts depends on the orientation of the motion. Therefore, it is pref
start and end position of the tube is aligned with the primary direction of motion, for example, vertically abo
patient undergoing a chest scan.
 BUILT IN FEATURES FOR MINIMIZING
MOTION ARTIFACTS
• Manufacturers minimize motion artifacts by using overscan and underscan modes, software
correction, and cardiac gating.
• Overscan and underscan modes: The maximum discrepancy in detector readings occurs between
views obtained toward the beginning and end of a 360° scan.
• Some scanner models use over scan mode for axial body scans, whereby an extra 10% or so is
added to the standard 360° rotation.
• The repeated projections are averaged, which helps reduce the severity of motion artifacts.
• The use of partial scan mode can also reduce motion artifacts, but this may be at the expense of
poorer resolution.
• Software correction: Most scanners, when used in body scan mode, automatically apply reduced
weighting to the beginning and end views to suppress their contribution to the final image.
However, this may lead to more noise in the vertical direction of the resultant image, depending
on the shape of the patient.
• Additional, specialized motion correction is available on some scanners.
• Cardiac gating –the rapid motion of the heart can lead to severe artifacts
in images of the heart and to artifacts that can mimic disease in
associated structures eg dissected aorta .
• To overcome these difficulties, techniques have been developed to
produce images by using data from just a fraction of the cardiac cycle,
when there is least cardiac motion.
• This is achieved by combining electrocardiographic gating techniques
with specialized methods of image reconstruction (4
Incomplete projections

• If any portion of the patient lies outside the scan field of view, the
computer will have incomplete information relating to this portion
and streaking or shading artifacts are likely to be generated.
• As the arms are outside the scan field, they are not present in the
image, but their presence in some views during scanning has led to
such severe artifacts throughout the image as to significantly degrade
its usefulness.
• Similar effects can be caused by dense objects such as an intravenous
tube containing contrast medium lying outside the scan field.
Ct image of the body
obtained with the
patient ,s arm down but
outside the scanning field
shows streaking artifacts
AVOIDANCE of INCOMPLETE
PROJECTIONS ARTIFACTS
• To avoid artifacts due to incomplete projections, it is essential to position
the patient so that no parts lie outside the scan field.
• Scanners designed specifically for radiation therapy planning have wider
bores and larger scan fields of view than standard scanners and permit
greater versatility in patient positioning.
• They also allow scanning of exceptionally large patients who would not fit
within the field of view of standard scanners.
• As an alternative, the CT system may be designed with reference detectors
on the tube side or with ray paths within the gantry to eliminate possible
interference with reference detectors on the tube side or with ray paths
within the gantry to eliminate possible interference with reference data
 PHYSIC
S BASED
ARTEFA
Physics-based artifacts result

CT
from the physical processes
involved in the acquisition of CT
data.
 1. BEAM HARDENING
• X-ray photons coming from a tube high are made up of a full spectrum
of x-ray energies, not just the voltage that the tube is set as
• The energy of a photon determines its level of attenuation when
passing through a sample, with low-energy photons attenuating much
faster than high-energy ones
• Therefore, when an x-ray beam begins to penetrate a sample material,
the lower energy x-rays preferentially attenuate, resulting in an overall
higher energy of the x-ray beam- Beam Hardening
 1.BEAM HARDENING
• The effect of beam hardening on a single material can
usually be managed by adjusting CT reconstruction
algorithms.
• However, if the sample contains multiple materialsto
within a single scan volume, imaging differing densities
simultaneously tends to result in atifact
 BEAM
0 HARDENING
CUPPING ARTEFACT
1 ARTEFACTS
• It happens when hardening is more prone to the center than the

0
periphery, therefore resembling a cup
• The resultant attenuation profile differs from the ideal profile that

2
would be obtained without beam hardening
• A profile of the CT numbers across the phantom displays a
characteristic cupped shape
 BEAM
0 HARDENING
STREAKS AND DARK BAND
1 ARTEFACTS
• In very heterogeneous cross sections, dark bands or streaks

0
can appear between two dense objects in an image
• If a high density material severely reduces transmission, the

2 detector may record no transmission and streaks and dark

band appear
 2. PHOTON
STARVATIO
N
• This is another cause of streak artefacts.
• In projections that have to travel through more material, eg
across the shoulders, as the x-ray beam travels through more x-
ray photons are absorbed and removed from the beam
• This results in a smaller proportion of noise.
• The streaks are due to the increased noise which is why they
occur in the direction of the widest part of the object being
scanned
 2. PHOTON STARVATION ARTEFACT
• Occurs in highly attenuating region due to inefficient
photons passing the widest part of the patient
• Manifestation of irregularities caused by noise in the raw
data profile is noted
• Image appears noisy with streaks
 3.PARTIAL
VOLUME
• It is a result of averaging the linear
ARTEFACT
coefficient in a voxel that is
heterogeneous in composition
• It arises when voxel contains many
types of tissues
• Arises essentially from reconstructing
low resolution images, typically thick
slide images
 3.PARTIAL
VOLUME
• It produces CT numbers as an average
ARTEFACT
of all types of tissues
• It appears as bands or streaks
• These artefacts are a separate problem
from partial volume averaging, which
yields a CT number representative of
the average attenuation of the materials
within a voxel
PARTIAL
VOLUME
ARTEFACTS
Partial volume artifact occurs when
tissues of widely different absorption are
encompassed on the same CT voxel
producing a beam attenuation
proportional to the average value of these
tissues
 4. UNDERSAMPLING
• The number of projections used to reconstruct a CT
image is one of the determining factors in image
quality
• Too large an interval between
projections(undersampling) can result in
misregistration by the computer of information
relating to sharp edges and small objects
4. UNDERSAMPLING
• This leads to an effect known as view aliasing,
where fine stripes appear to be radiating from
the edge of, but at a distance from, a dense
structure.
• Stripes appearing close to the structure are
more likely to be caused by undersampling
within a projection, which is known as ray
aliasing.
 Scanner based
Ring artefact
• Occurs if a fault detector and the detector do not have the same gain
relative to each other
• As the gantry rotates around the pt, this detector will outline a circle
• Solid state detector are more suspitable to ring artefact than xenon
gas detector
 Avoidance and software correction
• Presence of circular artefact is an indication that the detector gain
needs recalibration
• Correcting th scan field of view may reduce the artifact
 Tube arcing
• Occur when there is a short circuit within the tube
• The result is a temporal loss of x-ray output and localised artefact
Causes
• Insulator surface flashover
• Insulater breakover
• Vacuum flashover – this is the most common due to particulate
impurities or gas within the tube
Helical Artifacts
Spiral or windmill
Helical
• Helical scans can be affected by all of the artifacts explained so far.
However, there are additional artifacts that can occur in helical
scanning attributable to the helical interpolation and reconstruction
process.
• Helical scanning necessitated new image reconstruction methods
because now the table moved continuously during data collection and
the views needed to reconstruct the images were not all in the same
plane.
Helical pitch
• pitch = table feed per rotation / total width of the collimated beam.
• It shows whether data acquisition occurs with gaps (pitch > 1) or with
overlap (pitch < 1) in the longitudinal direction.
• When the beam collimation is opened too wide or when using large
reconstruction intervals, the intervals lead to large spaces between
adjacent image slices, which when reconstructed and placed side-by-
side, display large changes over small distances.
• Merging these slices leads to discontinuities in the image that can
appear as serrated edges or periodic horizontal stripes on sagittal and
coronal reformatted images.
Helical artifacts solution
• Interpolation can result in artifacts, particularly when anatomic
structures change rapidly in the z direction.
• These artifacts can best be avoided by using a low pitch whenever
possible.
Cone beam artifacts
Cone Beam
• The interpolation process becomes even more complicated as the
number of detector rows increase.
• Modern CT scanners use more detector arrays to increase the number
of sections acquired per rotation.
• These cone beam artifacts results on reconstruction, which appear
only on MDCT helical systems
Cone beam
• The cone-angle is largest for the slices at the outer edges of the detector
and it increases with an increasing number of detector rows if their width
is kept constant.
• The X-Rays diverge on their path from the tube to the detector. In the
reconstruction algorithm it is however detected as assumed parallel
beam geometry. This leads to a conically shaped distortion of the voxel.
• The artifact results from under-sampling along the z-axis during multislice
helical CT scanning, where several rows of detectors intersect the plane
of reconstruction during each rotation. In these instances, failure to
interpolate data properly between discrete detector locations produces
alternating black and white patterns that resemble vanes of a windmill
Cone Beam
• Cone-beam artifacts are errors in the reconstructed volume due to
incomplete radon data.
• This artifact occurs in areas with either steep or drastic Hounsfield unit
(HU) differential anatomical changes along the z-axis
• They appear as either streaks or as bright and dark shading near areas of
large density differences (e.g., bone and muscle). Cone beam artifacts
are more pronounced for the outer detector rows.
• These are most pronounced at high-contrast structures and increase
with increasing distance of the object from the iso-center. Typical
sources of cone-beam artifacts in medical images are the ribs or the
pelvic bones
Cone beam, solution
• Solutions:
• Implementing high-resolution reconstruction techniques or reconstructing thicker slices
may minimize windmill artifacts.These artifacts can be reduced with Adaptive Multiple
Plane Reconstruction (AMPR), which uses tilted planes for reconstruction .
• If re-scanning is needed, consider lowering the scan pitch and reducing the rotation time.
These adjustments should lessen the occurrence of these artifacts. They will ensure the
table moves through the CT bore at a decreased speed, as the source rotates around the
patient at an increased speed, enabling a more thorough collection of information.
• This is why certain protocols for 64-detector row scanners do not use all of the available
detector rows for data acquisition. In protocols in which high image resolution is
paramount and the speed of the scan acquisition is not as important, protocols may be
designed so that only the 32 center rows of the detector array are used